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Medical marijuana: 4,200 patients seen by physician assistants being denied and rejected

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The Colorado Department of Public Health and Environment has finally started denying and rejecting the 4,200 medical marijuana patients who were evaluated by a physician assistants and have been waiting for as long as four months for an answer. And as if the delay so far wasn't bad enough, many patients must wait another six months before they can get a license, because the state says they sent in a fraudulent application.

Back in December, the CDPHE announced that it would begin processing the applications, with the first round being sent back by year's end and the second round sent out later this month. Based on e-mails we've received from patients so far, it breaks down to this: If the physician assistant is the only person who signed off on the paperwork, the patient will be denied. If both a doctor and a physician assistant signed the paperwork, the patient will be rejected -- apparently even if the physician assistant was the one who performed the exam. CDPHE officials have confirmed as much in past conversations.

The difference in wording is subtle, but rejected applicants can reapply right away, while denied patients who thought they were submitting a valid application will essentially be punished by having to wait six months before applying again, or else go through a lengthy appeal process. CDPHE officials have said in the past that they aren't assessing blame, but the patients who are being denied don't see it that way.

Richard Hart is a 58-year-old retired nurse with severe back and neck pain and mounds of paperwork to back up his injuries. Like thousands of other patients, Hart went to a doctor's office for his medical marijuana evaluation this past fall and was seen by a physician assistant instead of a doctor. As I've said in the past, most patients who have dealt with chronic health issues have seen physician assistants as well as doctors over the course of their care. PAs are an integral part of the health-care process and it's not out of the ordinary for them to take on tasks that doctors traditionally handled. In short, it was just another day at the doctor's office for Hart, who says he figured the doctor entrusted with his care knew what he was doing.

Does he feel he deserves some blame? Hardly. "Using [the CDPHE's] argument that it's me, isn't it ironic that every person that went through this company all have been flagged and told they were defrauding the system?" Hart asks. "Clearly, we had nothing to do with it."

But not according to the CDPHE. "The department denies applications for which information has been received that confirms the patient was not seen by the physician for the marijuana recommendation," said CDPHE spokesman Mark Salley. "The department is responsible for operating the medical marijuana registry as created by Amendment 20, and as further refined by the state legislature. The law says the bona fide patient-physician relationship required for a medical marijuana recommendation includes an exam by a physician."

Rejected applications can reapply immediately and do not need to re-send in the application fee, now $35. Patients who are denied have to resubmit the application fee. According to Salley, the fee pays for the processing of the applications. But considering the MMJ registry has millions in surplus funding from applications fees being too high in the past, that's a hard pill to swallow. For patients like Hart, that $90 check was a sizable chunk of his already small budget.

Denied applicants can appeal the decision within thirty days. Marijuana attorney Robert Corey has created a form letter for patients to use, available at the Medical Marijuana Assistance Program of America website. MMAPA has collected several other resources for patients. Also, the Cannabis Business Alliance has partnered with attorney Warren Edson to provide free representation for patients during the hearing process.

More from our Marijuana archives: "Medical marijuana: CDPHE's Dr. Chris Urbina on physician assistants, patient denials" and " Med. marijuana patients must wait 6 months to reapply if applications found to be "fraudulent.'"


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27 comments
Кабель HDMI
Кабель HDMI

 If it were legal no one would be rejected and the government would be able to tax it and revamp the economy....

Jennifer
Jennifer

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o-v-e! right?

Matt Rize
Matt Rize

the argument for over regulation takes another hit. its just a plant folks. 

Muzzylu
Muzzylu

Seems like state governments are trying to force medical marijuana patients back into the arms of big pharmaceuticals and the liquor industry! How is marijuana worse than opiates or booze? But the government has to protect us from the evil cannabis.

Great e-book on medical marijuana: MARIJUANA - Guide to Buying, Growing, Harvesting, and Making Medical Marijuana Oil and Delicious Candies to Treat Pain and Ailments by Mary Bendis, Second Edition. This book has great recipes for easy marijuana oil, delicious Cannabis Chocolates, and tasty Dragon Teeth Mints!  http://goo.gl/iYjPn

Milkmemannow
Milkmemannow

and we wonder how the $90.00 submitted is used...

Monkey
Monkey

Please appeal this patients, if only to flood the CDPHE with complaints. Help them understand this attitude is not acceptable and they must spend years in appeals because of it. I know you didn't start this fight but please help finish it by appealing this irrational decision.

Concerned Patient
Concerned Patient

It was my understanding that if they didn't approve or deny the application within 35 days that it would be automatically approved. Why can they deny people then after 35 days?

Robert Chase
Robert Chase

It was a virtual certainty that the CDPHE would reject such applications -- evaluators were misled by the Department's apparently issuing some red cards at first; this was not an adequate indication that it would not then challenge 4,200 others.  If the legal theory under which physicians' assistants acting under a doctor's supervision can make recommendations for the use of cannabis is sound, the courts should uphold it.  As Salley alludes, the unconstitutional provision of SB10-109 requiring a personal examination by a physician gives the Department the pretext it has used to deny these applications.  As for at first approving some applications signed by a physician's assistant and a doctor, incompetence goes a long way in explaining the conduct of the CDPHE, and ignorance about and malice against medical cannabis explains the rest.

Warrenedson
Warrenedson

Please note that CBA has  partnered up with 3 law firms, Hoban & Feola, Edson Maytin & Matz LLP, and Vicente Sederberg LLC,  to help provide representation for patients.

High Country Caregiver
High Country Caregiver

Why deal with the CDPHE at all?  They don't want to play nice, just don't play!

annon
annon

Well Docs isnt owned by the same people anymore. They were avoiding phone calls and their voice mail was full for about two weeks. After that they sold to a new guy, who kept the phone number and name, but has brought in a new Dr. I haven't heard any feedback from people going back to get their issues fixed, but these people should know that they aren't dealing with the same company anymore, for better or worse.

Dorkee
Dorkee

if you go, please tell us how it goes..

Michael Roberts
Michael Roberts

Interesting approach, Monkey. Thanks for sharing your thoughts.

Colorado Mmj Patient
Colorado Mmj Patient

Because THEY don't have to follow the law.  If they had any respect for the law, they would help facilitate the wishes of Colorado voters instead of obstructing them.  They are mean people who will accuse thousands of "fraud" as if it it was a conspiracy among patients - who simply went to the doctor and did absolutely nothing wrong - yet these a$$holes will punish patients and deny them their medicine.  Imagine if it was insulin, for example.  "PAs are an integral part of the health-care process and it's not out of the ordinary for them to take on tasks that doctors traditionally handled. In short, it was just another day at the doctor's office for Hart, who says he figured the doctor entrusted with his care knew what he was doing."The Dept of Health and any govt agency with influence on medical care should be more concerned about health than punishment.But that's too logical and denies these little Napoleons their 15 minutes of POWER over those horrible weed smokers. I believe to properly accuse someone of "fraud" they have to have known.  But, clearly, these nasty people know only enough about the law to try to twist it into some perverted attack on ill Coloradans.David

Gammiehaus
Gammiehaus

Cause they own the game and all the players.

Citizen80919
Citizen80919

If you look at the constitution it states that you are legal after 35 days until you are denied.  It states this in the last line below.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

(d) Except for patients applying pursuant to subsection (6) of this section, where the state health agency, within thirty-five days of receipt of an application, fails to issue a registry identification card or fails to issue verbal or written notice of denial of such application, the patient's application for such card will be deemed to have been approved. Receipt shall be deemed to have occurred upon delivery to the state health agency, or deposit in the United States mails. Notwithstanding the foregoing, no application shall be deemed received prior to June 1, 1999. A patient who is questioned by any state or local law enforcement official about his or her medical use of marijuana shall provide a copy of the application submitted to the state health agency, including the written documentation and proof of the date of mailing or other transmission of the written documentation for delivery to the state health agency, which shall be accorded the same legal effect as a registry identification card, until such time as the patient receives notice that the application has been denied.

Robert Chase
Robert Chase

-- because the Constitution means nothing to these people.  The theory goes like this:  during the period in which the CDPHE is failing to do its constitutionally-mandated duty to process patients' applications and issue or deny red cards (i.e. after thirty-five days have passed without a response), patients ARE deemed to be approved, as per the Constitution (they just don't have a red card).  When and if the Department gets around to evaluating the application and citing some pretext under which it should have been denied had the Department acted (as legally required) during the thirty-five days since the application was postmarked, it acts in its capacity as the administrator of the patient-registry to maintain its accuracy by revoking the status of patients whose submission they deem fraudulent (or inaccurate, incomplete, missing a dot over an "i"; what have you).  Because this is Cawleraduh, the CDPHE flouts its duty to process the application in a timely manner with utter impunity, despite the fact that the Department has done an end-run around the constitutional provision that patients' applications are deemed approved after thirty-five days of departmental inaction and that applications must be made annually.  The Courts should strike down the unconstitutional depredations of the General Assembly and the Board of Health (led around by its metaphorical nose by the Department).

guest
guest

went yesterday.  doctor had signed our original back in sept but PA did exam and initialed her comments and this is the reason given for rejection.  saw the doctor yesterday for free, however, he will recommend edibles but he wants more $ for more plants which is a new required field on the newly updated forms from the dept of harrass... er.. i mean health...  don't know if he had any denials...

annon
annon

Well Docs isnt owned by the same people anymore. They were avoiding phone calls and their voice mail was full for about two weeks. After that they sold to a new guy, who kept the phone number and name, but has brought in a new Dr. I haven't heard any feedback from people going back to get their issues fixed, but these people should know that they aren't dealing with the same company anymore, for better or worse.

Guest
Guest

Well Docs was part of the problem of this whole mess. Their applications were mostly the ones scrutinized by the CDPHE. Glad to see they are trying to make up for it by offering free exams. It's not worth it to pay more for an "edibles" recommendation for more plants. Having more than six plants even with a doctors recommendation is not guaranteed to you under the law, it must be contested in court and the doctor will be subpeonaed for it. It might be an extra fee incurred by the CDPHE or the doctor but either way it's not really worth it for patients. You take a risk that you end up paying for in court fees if it comes down to that.

Dorkee
Dorkee

cripes. if someone has to come back a second time, throw them the edibles rec!

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